双能X线吸收测定法联合骨折联络服务对髋关节骨折患者预后效果分析  

Analysis of the prognostic effect of dual energy X-ray absorptiometry combined with fracture liaison service on patients with hip joint fractures

作　　者：李通宪 高峰 武飞 杨建波 LI Tongxian;GAO Feng;WU Fei(Xingtai General Hospital of North China Medical and Health Group,Hebei,Xingtai 054000,China)

机构地区：[1]华北医疗健康集团邢台总医院,河北省邢台市054000

出　　处：《河北医药》2024年第3期380-383,共4页Hebei Medical Journal

基　　金：河北省邢台市科技支撑计划项目(编号:2021ZC070)。

摘　　要：目的评估双能X线吸收测定法联合骨折联络服务(FLS)对骨质疏松性髋关节骨折患者预后及骨质疏松改善效果分析。方法以2018年6月至2020年6月诊断为骨质疏松且未实施FLS的髋关节骨折患者50例为对照组,以2020年6月至2022年6月诊断为骨质疏松且实施了FLS干预的髋关节骨折患者50例为试验组。随访2组患者年龄、性别、骨折部位、骨质疏松的评估结果、患者骨质疏松的自我管理、是否发生二次骨折以及医务人员的宣教率;比较2组患者术前与术后6个月髋关节Harris评分以及2组患者入院与出院1年血清25(OH)D3水平差异。结果FLS实施后,护士骨质疏松宣教执行率、有效随访率较前提高。患者自我管理行为提高、骨质疏松较前改善,BMD值提高,二次骨折发生率降低,术后6个月试验组患者髋关节Harris评分高于对照组,出院1年试验组血清25(OH)D3水平高于对照组,且差异均有统计学意义(P<0.05)。结论双能X线吸收测定法联合FLS能够有效提高医务人员宣教率、患者自我管理行为依从率,降低二次骨折发生率,并有益于患者髋关节功能的恢复和骨质疏松的预防,是一种行之有效的治疗骨质疏松性骨折方法,值得推广应用。Objective To evaluate the effect of dual-energy X-ray absorptiometry combined with fracture liaison service(FLS)on the prognosis and improvement of osteoporosis in patients with osteoporotic femoral neck fractures.Methods A total of 50 osteoporosis patients with hip joint fractures and without the management of FLS in our hospital from June 2018 to June 2020 were taken as the control group,and 50 osteoporosis patients with hip joint neck fractures and managed by FLS from June 2020 to June 2022 were taken as the experimental group.The age,sex,fracture site,evaluation results of osteoporosis,self-management of osteoporosis,occurrence of secondary fractures and the rate of education provided by medical staff were followed up in the two groups.The Harris Hip Score(HHS)of the hip joint before and 6 months after operation and the level of serum 25(OH)D3 at admission and 1 year after discharge were compared between the two groups.Results After the implementation of FLS,the implementation rate of osteoporosis education and effective follow-up rate provided by nurses were significantly higher than before.Patients in the experimental group presented significantly better self-management behavior,improved osteoporosis,higher percentage change in bone mineral density BMD,and lower incidence of secondary fractures than those of control group(P<0.05).At 6 months postoperatively,the HHS score in the experimental group was significantly higher than that of control group(P<0.05).At 1 year of discharge,serum 25(OH)D3 level was significantly higher than that of control group(P<0.05).Conclusion Dual-energy X-ray absorptiometry combined with fracture contact service can effectively improve the rate of propaganda and education provided by medical staff,the compliance rate of patients’self-management behavior,and the situation of osteoporosis,and reduce the incidence of secondary fractures.It is an effective method for the treatment of osteoporotic fractures,which is worthy of popularization and application.

关 键 词：骨质疏松 骨折联络服务 骨密度 髋关节骨折 并发症 

分 类 号：R683[医药卫生—骨科学]